| Entity Name: | WEST COAST EYE INSTITUTE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 08 Jun 1987 (38 years ago) |
| Document Number: | J76934 |
| FEI/EIN Number | 000000000 |
| Address: | 333 S. TAMIAMI TRAIL, SUITE #395, VENICE, FL, 34285 |
| Mail Address: | 333 S. TAMIAMI TRAIL, SUITE #395, VENICE, FL, 34285 |
| ZIP code: | 34285 |
| County: | Sarasota |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1093810434 | 2006-09-13 | 2020-08-22 | 10332 N CITRUS SPRINGS BLVD, CITRUS SPRINGS, FL, 344343217, US | 10332 N CITRUS SPRINGS BLVD, CITRUS SPRINGS, FL, 344343217, US | |||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 352-489-2240 |
| Fax | 3524892270 |
Authorized person
| Name | DR. JOHN W ROWDA |
| Role | PRESIDENT |
| Phone | 3524892240 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | OP1974 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207W00000X - Ophthalmology Physician |
| License Number | OS0004322 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207W00000X - Ophthalmology Physician |
| License Number | ME0060384 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 40218 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HRIC, MICHAEL | Agent | 2801 FRUITVILLE RD, SARASOTA, FL, 33577 |
| Name | Role | Address |
|---|---|---|
| SHOEMAKER, DAVID W. | President | 333 S. TAMIAMI #395, VENICE, FL |
| Name | Role | Address |
|---|---|---|
| SHOEMAKER, DAVID W. | Secretary | 333 S. TAMIAMI #395, VENICE, FL |
| Name | Role | Address |
|---|---|---|
| SHOEMAKER, DAVID W. | Treasurer | 333 S. TAMIAMI #395, VENICE, FL |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| INVOLUNTARILY DISSOLVED | 1989-10-13 | No data | No data |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
